CDR Marty Cavins

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MAGTF LOGISTICS PLANNING
HEATLH SERVICES SUPPORT OPERATIONS

• CDR Marty Cavins

010601
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PURPOSE

• Develop a knowledge of combat epidemiology
• Gain an awareness of the Patient Movement
  system, which includes Medical Regulating
• Discuss how medical planners need to be
  integrated into the MCPP and the interactions
  they need at the MAGTF, component, and joint
  levels

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REFERENCES
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HSS MISSION
MSTP

• The Health Service Support (HSS) mission is to
  minimize the effects that wounds, injuries, and
  disease have on units effectiveness, readiness,
  and morale. (MCWP 4-11.1)
• The HSS units job is to help the Commander
  accomplish his mission.
• BOTTOM LINE Provide for a healthy fighting
  force supported by a combat ready health care
  system.

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CIVILIAN VS. MILITARY TRAUMA
Civilian
Combat

• Blunt Trauma
• Initial evacuation is to a trauma center
• Treatment is completed at one facility, by one
  team of HSS professionals
• Air transport is dedicated

• Penetrating Injuries
• Initial evacuation is to an aid station
• Treatment at multiple facilities thousands of
  miles apart, by many different HSS professionals
• Air transport is frequently lift of opportunity

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CAUSES OF DEATH
(From the Wound Data Munitions Effectiveness Team
(WDMET) study in Vietnam)

• Major treatable cause of death from combat
  injuries is bleeding to death

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TIME - WOUNDING TO DEATH
(From WDMET)

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DISTRIBUTION OF WOUNDED
(From WMDET)
100
Some will live no matter what you do Some
will live or die depending on what you do Some
will die no matter what you do
Slightly WIA (65)
35
Seriously WIA (15)
20
KIA (20)
0
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WHAT DOES THIS DATA MEAN?

• Barring any new medical miracles the greatest
  impact we can have will be on the seriously
  wounded group
• Earlier surgery for those who would quickly bleed
  to death is where we need to put the medical
  resources to make an impact

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SIGNIFICANCE OF DISEASE
US Army Hospital Admissions, shown as a percent
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SIGNIFICANCE OF DISEASE

• DNBI accounts for most man days lost in combat
• Less mortality from disease
• Logistically easier to support treatment of
  disease
• Less urgency in initial treatment compared to
  injuries
• More potential for return to duty
• Can eliminate or reduce with a good preventive
  medicine plan
  

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WHAT IS MEDICAL REGULATING?
Patient Movement
Tactical and Strategic Evac
Primary and Secondary Evac
Med Evac
Forward Aeromedical Evacuation
Dust Off
Medical Regulating
Patient Evacuation
Aeromedical Evacuation
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DEFINITIONS
Medical Regulating The actions and
coordination necessary to arrange for the
movement of patients through the echelons of
care. This process matches patients with a
Medical Treatment Facility (MTF) which has the
necessary HSS capabilities, and it also ensures
that bed space is available. (MCWP
4-11.2) Patient Evacuation The process of
moving any person who is wounded, injured, or ill
to and/or between MTFs. (MCWP
4-11.2) Patient Movement The act or process
of moving a sick, injured, wounded, or other
person to obtain medical/dental care or
treatment. Decisions made in this process
involve coordination between the sending MTF, the
gaining MTF, the MRCO, the LF PEO, and/or the
GPMRC/TPMRC. (MCWP 4-11.2)
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ELEMENTS OF PATIENT MOVEMENT

• Tactical or Clinical decision that the casualty
  needs to move
• Finding a medical treatment facility with an
  available bed and appropriate capability
• Finding a way to get the casualty to the above
  facility

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EVACUATION POLICY

• Theater evacuation policy is set by SecDef in
  coordination with the geographical combatant
  commander (CINC) prior to OPLAN execution
• Upon execution, the theater evacuation policy is
  adjusted by the CINC as needed
• Generally expressed as in number of days

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EVACUATION POLICY

• Considerations in planning the evacuation
• policy
• Number of patients
• Means of evacuation
• Availability of replacements
• Availability of theater resources
• Timeliness (response, mobilize, build up)

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TRAC2ES

• TRANSCOM Regulating and Command and Control
  Evacuation System (TRAC2ES)
• Combines the elements of finding a bed and
  finding a way to move the patient (lift bed
  planning) into one automated system
• Lift bed planning (current 400 pts/30 min,
  TRAC2ES 1,750 pts/30 min.
• It establishes patient In-Transit Visibility
  (ITV) within 5 min.
• Operational by OCT 2000

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PLANNING HSS

• What is the interaction of HSS in the planning
  process?

• Significant contributions or important
  situational awareness to take away in each step

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MISSION ANALYSIS
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COA DEVELOPMENT
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COA WAR GAME
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COA COMPARISON DECISION
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ORDERS DEVELOPMENT
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TRANSITION
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MAGTF HSS ASSETS
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JOINT HSS ASSETS FOR MAGTF
Air Ambulance Co.

• Joint HSS assets available that we may need to
  include in planning

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SUMMARY

• Developed a knowledge of combat epidemiology
• Gained an awareness of the Patient Movement
  system, including Medical Regulating
• Discussed how medical planners need to be
  integrated into the MCPP and the interactions
  they face at the MAGTF, component, and joint
  levels